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Establishing a professional role is a prerequisite for establishing control over practice in the domain of nursing which includes clinical care, research, education, policy and administration.

Professionalism is having a high standard of skill, knowledge, good judgement and polite behaviour that is expected of a practicing nurse who has been trained to be efficient in her job. Abraham Flexner identified several characteristics related to professionalism, which are: knowledge, specialization, intellectual and individual responsibility and well-developed group consciousness. Authors from various fields have since provided different perspectives on what professionalism means, including knowledge based on scientific principles, accountability, autonomy, inquiry, collegiality, collaboration, innovation inclined with ethics and values.

Nursing and health care practices intersect in interdisciplinary spaces. Inter-professionalism is being intentionally extended through health care in response to economic, human resource and patient safety conditions needing to be addressed. As such, health care providers engage in teams (e.g. Nurses, doctors, Pharmacists, Physiotherapist, Pathologist, Radiologists, Vocational therapists, Dietitians, prosthetists, orthotists etc.)
Health care team’s work and processes are essential components to consider in exploring relationships of individuals brought together inter-professionally to form a team. However, the roles of each team members are at times obscured through layers of power, expectations, stereotypes, trust, understanding, personalities and multitude of other factors that contribute to the complicated nature of health care interactions.

This complicated nature of health care interaction is unfortunately worse intra-professionaly. Interdisciplinary team a group of health care professionals from diverse fields who work in a coordinated fashion toward a common goal for the patient. Example of such group in developed countries are RN (inpatient, ambulatory, etc.)and Advanced Practice Nurses (Clinical Nurse Specialists, Adult/ Child Nurse Practitioners and Primary Nurse Practitioners etc.)
Example of such group in developing countries like Nigeria are RN- orthopaedics, midwifery, accident and emergency, ophthalmic etc (in various specialties with cumulation not amounting to BNSC) , BNSc, MSc Nursing and Phd. (Evaluation of Nigerian Nursing Programmes, and Certification is a presentation for another day).

Intra-professional relations are important topics both for nurses and nursing as we face the ongoing challenges of nurse shortages. Poor colleague relationships, together with workplace conflict, amongst others cause job dissatisfaction. As a consequence, some nurses leave the profession while others continue working but remain chronically unhappy.

Health care environments have become a challenge in recent years due to constant restructuring in an effort to achieve greater efficiency and productivity. These environments have been characterized by rapid change and influences in human resource strategies such as the movement toward flexible workforces.
As medical advances increases, technological advances in patient care have lead to increase demand for more medical procedures and providers who can perform them. Hence, the demand for knowledgeable healthcare practitioners to continue to grow.

Changes have been evident across all settings, making it a chaotic and occasionally unstable work environment. Recognizing that it is sometimes difficult to maintain professionalism in a changing health care setting.
Considering the expected ability of a nurse to BALANCE the following:
• quality and time in COMPLIANCE
• efficiency and effectiveness in CHARACTER
• co-workers’ and clients’ satisfaction/comfort with JOB DESCRIPTION
• Personal and organizational COMMITMENT
• COGNIZANCE based on experience,
• What you say and what they understand in EFFECTIVE COMMUNICATION
• what you see, hear, observe and what you are expected to write in DOCUMENTATION and
• favourable or adverse productivity output of nursing care rendered,
The speaker wonders…….……………………
Has the influence of inter-professionalism swayed nursing, or can the profession and discipline of nursing alter the world of health care inter-professionalism?

Here are recommendations of strong professionalism

1. Knowledge = Seek knowledge that is theoretical, practical and clinical. Being able to apply that knowledge. Using theoretical and/or evidence-based rationale for practice. Synthesizing information from a variety of sources. Using information or evidence from nursing and other disciplines to inform practice. Sharing or communicating knowledge with colleagues, clients, family and others to continually improve care and health outcomes.

2. Spirit of Inquiry = Being open-minded and having the desire to explore new knowledge. Asking questions leading to the generation of knowledge and refinement of existing knowledge. Striving to define patterns of responses from clients, stakeholders and their context. Being committed to life-long learning.

3. Accountability = Understanding the meaning of self-regulation and its implications for practice. Using legislation, standards of practice and a code of ethics to clarify one’s scope of practice. Being committed to work with clients and families to achieve desired outcomes. Being actively engaged in advancing the quality of care. Recognizing personal capabilities, knowledge base and areas for development

4. Autonomy = Working independently and exercising decision-making within one’s appropriate scope of practice. Recognizing relational autonomy and the effects of the context and relationships on this autonomy. Becoming aware of barriers and constraints that may interfere with one’s autonomy and seeking ways to remedy the situation.

5. Inquiry = Understanding the client’s perspective. Assisting the client with their learning needs. Being involved in professional practice initiatives and activities to enhance health care. Being knowledgeable about policies that impact on delivery of health care.

6. Innovation = Visionary concept. Fostering a culture of innovation to enhance client/family outcomes. Showing initiative for new ideas and being involved through taking action. Influencing the future of nursing, delivery of health care and the health care system. Collegiality.

7. Collaboration = Developing collaborative partnerships within a professional context. Acting as a mentor to nurses, nursing students and colleagues to enhance and support professional growth. Acknowledging and recognizing interdependence between care providers.

8. Ethics and Values = Knowledgeable about ethical values, concepts and decision-making. Being able to identify ethical concerns, issues and dilemmas. Applying knowledge of nursing ethics to make decisions and to act on decisions. Being able to collect and use information from various sources for ethical decision-making. Collaborating with colleagues to develop and maintain a practice environment that supports nurses and respects their ethical and professional responsibilities. Engaging in critical thinking about ethical issues in clinical and professional practice.


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